Mandatory reporting

In Canada, provincial, territorial and federal statutory requirements mandate that physicians must report specific patients to the appropriate agencies.

In some instances if the physician fails to report confidential information to a public authority and thereby fulfil the statutory obligation, the physician may be prosecuted, fined, or face imprisonment.

Some examples of mandatory reporting situations include:

a child in need of protection (to prevent physical, sexual, or emotional harm, or abandonment)

Background

A father brings in his four-year-old child because the child is not weight bearing following a "fall from a swing."

X-rays of both lower extremities reveal a new fracture and other healing fractures. The father denies the child has ever been injured.

Think about it

In addition to providing clinical care for the fracture, what is your best next step?

Outcome

Report your suspicion that the child may be in need of protection to the child protection authorities. The purpose is protection, not accusation. The authorities will investigate further.

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If a physician has reason to believe a child is in need of protection, the physician is responsible for seeing that the appropriate authority is informed in a timely manner.

The child should not be put at risk by any delay or delegation of the act of reporting.

Every Canadian province and territory has enacted legislation requiring physicians to report children who may be in need of protection, including instances of suspected child abuse, to the child welfare authorities or the equivalent agency in the province or territory. The duty to report is mandatory even though the information reported may otherwise be confidential.

Key concepts

Maintaining a patient's personal health information in confidence is an ethical and legal requirement.

Confidentiality is central to the doctor-patient relationship because it encourages patients to be frank with their doctor.

Breaches of confidentiality can be harmful to patients, physicians, and other health providers.

Most breaches are unintentional.

In specific circumstances you are required to divulge patient information. Know the legislation in your province or territory.

Divulging patient information is permitted if there is an imminent, credible risk of serious bodily harm to a recognized individual or group of individuals.

Legal and professional standards for the protection of privacy are equally applicable to electronic communications.